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State Univ. of Iowa, 1916, Thesis (Doctoral) / Includes bibliographical references (p.160-166). - RLIN, CTRG95-B1869. - Reproduction of original from Harvard Law School Library

Made available in DSpace on 2016-12-23T13:55:57Z (GMT). No. of bitstreams: 1 Priscila Ventorim Lisboa Ferreira.pdf: 1031724 bytes, checksum: c897be36746643eea3eee9da896e7d40 (MD5) Previous issue date: 2013-08-14 / Introdução: Diversas alterações cutâneas têm sido descritas nos pacientes transplantados renais, sendo a maior parte delas relativas aos efeitos imunossupressores diretos ou aos efeitos colaterais das drogas e podem ser agrupadas em infecções virais, bacterianas e fúngicas, lesões pré-neoplásicas e neoplásicas e iatrogênicas. Objetivos: 1- Determinar os agentes etiológicos e formas clínicas das micoses observadas nos pacientes transplantados renais estudados. 2- Correlacionar a ocorrência de micose com esquema imunossupressor. 3- Avaliar a prevalência de micoses em relação às dermatoses bacterianas e virais. Materiais e métodos: Estudo descritivo tipo corte transversal, com amostragem por conveniência, que avaliou 82 pacientes transplantados renais em regime de medicações imunossupressoras, atendidos em um hospital da Grande Vitória (ES), nos anos de 2011 e 2012. Após exame dermatológico foram realizados exames micológicos através de microscopia e cultura, quando necessários. Resultados: A casuística consistiu, na maioria, de pacientes do sexo masculino, pardos e com média de idade de 49,2 anos. O esquema imunossupressor mais frequente foi a combinação de Prednisona + Tacrolimus + Micofenolato sódico (46,3%) e foi o mais relacionado às dermatomicoses. O percentual de dermatomicoses foi de 28%, sendo 19,5% de onicomicoses, 6,1% de pitiríase versicolor e 2,4% de tineas. Com relação às dermatoses infecciosas, 7,3% apresentaram verrugas vulgares, 2,4% herpes simples e o mesmo percentual de 1,22% para molusco contagioso, erisipela e furunculose. O grupo de pacientes com transplante tardio (entre 3 e 5 anos) foi o que apresentou maior frequência de dermatomicoses. Conclusões: Os aspectos clínicos das dermatomicoses foram semelhantes, porém mais freqüentes que aqueles observados na população em geral. O percentual de dermatoses infecciosas foi similar ao da população imunocompetente / Introduction: Several cutaneous changes have been reported in renal transplant recipients, most of them due to immunosuppressive effects or side effects of the drugs and can be grouped into viral, bacterial and fungal infections, pre-neoplastic and neoplastic, and iatrogenic. Objectives: 1 - Determine the etiologic agents and clinical forms of mycoses observed in renal transplant recipients studied. 2 - Correlate the occurrence of fungal infection with immunosuppressive regimen and time of transplantation. 3 - Evaluate the frequency of bacterial and viral skin diseases. Materials and Methods: Descriptive cross-sectional study with convenience sampling, which evaluated 82 renal transplant recipients under immunosuppressive medications, treated at a hospital in Vitória (ES) in the years 2011 and 2012. After dermatological examination, skin scrapings were performed by light microscopy and mycological culture. Results: The sample consisted mostly of males and a mean age of 49.2 years. The most frequent regimen was the combination of Prednisone + Tacrolimus + Mycophenolate sodium (46.3%) and it was the most related to dermatomycoses. The frequency of dermatomycoses was 28%, with 19.5% of onychomycosis, 6.1% of pitiryasis versicolor and 2.4% of Tineas. We also found 7.3% of common warts, 2.4% of herpes simplex and the same percentage of 1.22% for molluscum contagiosum, erysipelas and furunculosis. The group of patients with late transplant (between 3 and 5 years) showed the highest frequency of dermatomycoses. Conclusions: The clinical aspects of dermatomycoses was similar but it was more frequent than that observed in the general population. The percentage of cutaneous infections was similar to that of immunocompetent population

Made available in DSpace on 2015-03-26T13:47:29Z (GMT). No. of bitstreams: 1 texto completo.pdf: 1590039 bytes, checksum: 13d7ea7a1ad688110149bf5448ece2d8 (MD5) Previous issue date: 2003-05-08 / This work had as objective the administration of an luteolytic agent (Cloprostenol Sodic-Ciosin) in different doses and routes, to evaluate the synchronization rates, interval of the application to the estrus, hormonal plasma concentrations of progesterone (P4) and pregnant rates of fresh embryos transferred. Still, genital organs of bovine females were collected at slaughterhouses for the study of the angioarchitecture, through veined infusions of radiographic contrasts. There were used 199 Holstein-Zebu embryo recipients with corporal score &#8805; 3,0 in a scale from 1 to 5 and live weight among 320-450 kg. A total of 103 animals presented historic of estrus previous to the treatments (between days 7-16 of the estrous cycle; estrous = day 0) and 96 animals didn't present historic of estrous, these were examined by rectal palpation for the presence of ripe CL in one of the ovaries. The animals were randomly assigned to three experimental groups. Treatment 1: 68 animals (38 with report of previous estrus) received 1 mL of Cloprostenol via intra-vulvo-submucosal (IVSM). Treatment 2: 66 animals (33 with report of previous estrus) received 1 mL of Cloprostenol via intramuscular (IM) and in Treatment 3, 65 animals (32 with report of previous estrus) received 2 mL of Cloprostenol via IM. It was considered immobility reflex as an indicative of estrous and only the animals that showed estrus up to 96 hours after the application of the Cloprostenol were used. The averages of plasma progesterone concentrations (P4) were analyzed by RIA in the moment previous to the application of the drug and 48 hours after. There was no difference in synchronization rates (P>0,05) between the three treatments (72,1%, 53,0% , 64,6%, respectively), when just the animals with report of previous estrus were appraised (76,3%, 60,6% , 68,8%, respectively) and when the animals without report of previous estrus were appraised (66,7%, 45,5% , 60,6%, respectively). The answer interval to the estrus was similar (p >0,05) among the three treatments (69,3± 15,2; 67,9± 16,7; 68,3± 16,9 hours, respectively), but they showed differences (p<0,05) when the animals with report of estrus were divided in luteal classes, in witch animals belonging to days 11-13 of estrous cycle showed larger intervals (75,3 ± 13,3 hours), in relation to days 7-10 of the estrous cycle (63,6 ± 18,3 hours) and to days 14-16 (61,1 ± 11,3 hours). Synchronization rates were similar among the three luteal classes (P>0,05). Regarding pregnant rates there were not differences (P>0,05) in the animals fertility among the three treatments, (45,5%, 50,0%, 55,0% respectively). As for the plasma P4 concentrations, the percentile fall of the progesterone values after 48 hours of the application was similar (p>0,05) in the three treatments (79%; 68% and 83%, respectively). Regarding the angioarchitecture of the genital organs it was observed through radiographic sheets that the caudal vaginal vein drains the vagina mucosal and it presents anastomoses with the vases from the cervix, body and uterine horns. The present study demonstrated that embryo recipients with and/or without report of previous estrus, when synchronized with Sodic Cloprostenol in reduced doses (50% of the conventional), as by IM or IVSM roads showed similar synchronization rates, answer intervals to the estrus, fall of the progesterone concentrations and pregnat rates. The variations in the answer intervals to the estrous are influenced by the diestrous phase in the moment of treatment and not for the route or dose of administration of an luteolytic agent. A portion of luteolytic agents administered through IVSM can be transported directly to the uterus and consequently to the ovary for a local route without passing for the systemic circulation is suggested. / Este trabalho teve como objetivo a administração de um agente luteolítico (Cloprostenol Sódico-Ciosin®) em diferentes doses e vias, para avaliar as taxas de sincronização, intervalo da aplicação ao estro, concentrações de progesterona sérica (P4) e taxas de gestação de embriões transferidos à fresco em receptoras de embrião bovino. Ainda, órgãos genitais de fêmeas bovinas foram coletados em matadouros para o estudo da angioarquitetura, por meio de infusões venosas de contrastes radiográficos. Foram utilizadas 199 receptoras mestiças Holandês-Zebu com escore corporal &#8805; 3,0 numa escala de 1 a 5 e peso vivo entre 320-450 kg. Um total de 103 animais apresentavam histórico de estro anterior aos tratamentos (entre os dias 7-16 do ciclo estral; estro= dia zero) e 96 não apresentavam histórico, apenas selecionados pela palpação transretal para a presença de CL característico em um dos ovários. Os animais foram divididos ao acaso em três grupos experimentais. No Tratamento 1: 68 animais (38 com histórico de estro anterior) receberam 1 mL de Cloprostenol na parede interna da vulva (IVSM). Tratamento 2: 66 animais (33 com histórico) receberam 1 mL de Cloprostenol via intramuscular (IM) e no Tratamento 3: 65 animais (32 com histórico) receberam 2 mL de Cloprostenol via IM. Considerou-se o reflexo de imobilidade como indicativo do estro e somente foram considerados para os estudos os animais que manifestaram estro até 96 horas após a aplicação. As médias das concentrações de Progesterona Séricas (P4) foram analisadas por RIA no momento anterior à aplicação da droga e 48 horas após. Não houve diferença na taxa de sincronização (P>0,05) entre os três tratamentos (72,1%, 53,0% e 64,6% respectivamente), quando apenas os animais com histórico foram avaliados (76,3%, 60,6% e 68,8%, respectivamente) e quando os animais sem histórico foram avaliados (66,7%, 45,5% e 60,6%, respectivamente). O intervalo de resposta ao estro foi semelhante (p>0,05) entre os três tratamentos (69,3± 15,2; 67,9± 16,7; 68,3± 16,9 horas, respectivamente), mas apresentaram diferenças (p<0,05) quando os animais com histórico foram divididos em classes luteais, nas quais os animais pertencentes aos dias 11-13 do ciclo estral apresentaram intervalos maiores (75,3 ± 13,3 horas) de resposta ao estro, em relação aos animais dos dias 7-10 do ciclo (63,6 ± 18,3 horas) e os animais dos dias 14-16 (61,1 ± 11,3 horas). Mas a taxa de sincronização foi semelhante entre as três classes luteais (P>0,05). Em relação à taxa de gestação não houve diferenças (P>0,05) nos três tratamentos (45,5%, 50,0% e 55,0% respectivamente). Quanto a P4, a queda percentual dos valores de progesterona após 48 horas da aplicação foram semelhantes (p>0,05) nos três tratamentos (79%; 68% e 83%, respectivamente). Em relação à angioarquitetura dos órgãos genitais, foi observado por meio de lâminas radiográficas, que a veia vaginal caudal drena a parede da vagina e apresenta anastomoses com os vasos provenientes da cérvix, corpo e cornos uterinos. Este presente estudo demonstrou que receptoras bovinas com e/ou sem histórico de estro anterior, quando sincronizadas com Cloprostenol Sódico em doses reduzidas (50% da convencional), tanto pelas vias IM ou IVSM apresentam taxas de sincronização, intervalos de resposta ao estro, queda das concentrações de progesterona e taxas de gestação semelhantes. As variações nos intervalos de resposta ao estro são influenciadas pela fase de diestro em que o animal se encontra no momento do tratamento e não pela rota ou dose de administração de um agente luteolítico. Sugere-se ainda que parte da dosagem de agentes luteolíticos administrados via IVSM pode ser transportada diretamente ao útero e, por conseguinte ao ovário por uma rota local sem passar pela circulação sistêmica.

A doença hepática terminal reduz de forma significativa a qualidade de vida de pacientes e com o transplante do órgão é possível melhorar as condições de saúde. A sexualidade é aspecto central do ser humano durante todo o ciclo vital. É área complexa do comportamento humano, assim a sexualidade de candidatos e receptores de transplante de fígado não deve ser menosprezada. O presente estudo teve como objetivo analisar as evidências disponíveis na literatura sobre as alterações na sexualidade de candidatos e receptores de transplante de fígado. Trata-se de revisão integrativa da literatura: as bases de dados selecionadas para a busca dos estudos primários foram PubMed, CINAHL e LILACS. Os 16 estudos primários incluídos na revisão foram agrupados em três categorias: (1) sexualidade feminina (n=5); (2) sexualidade masculina (n=5) e; (3) sexualidade masculina e feminina (n=6). Na categoria 1, os principais temas de investigação foram contracepção, gravidez, disfunção sexual, presença de sintomas ginecológicos e doença sexualmente transmissível. Na categoria 2, o foco principal dos estudos primários agrupados foi a disfunção erétil e investigou-se também desejo/satisfação sexual e as consequências de homens que tiveram filhos, em regime imunossupressor com ácido mycofenólico. Na categoria 3, a avaliação da função sexual foi o principal tema abordado nas pesquisas analisadas. A sexualidade é problemática desafiadora, revestida por tabus e preconceitos, vivenciada de forma diferente pelos indivíduos. Assim, os pacientes podem apresentar dificuldades em relatar para os profissionais da saúde seus problemas, acarretando atraso do diagnóstico e tratamento, prolongando a sensação de desconforto e sentimento de angústia. A dificuldade em abordar sobre sexualidade também ocorre por parte dos profissionais de saúde que não recebem capacitação adequada. O conhecimento sobre as dúvidas e problemas vivenciados pelos candidatos e receptores de transplante de fígado pode proporcionar a implementação de intervenções direcionadas para prevenção, redução ou controle das complicações no período pré e pós-transplante. O presente estudo forneceu subsídios para encorajar os profissionais de saúde a incorporar a sexualidade na rotina de atendimento destes pacientes, bem como indicou lacunas no conhecimento para a condução de novas pesquisas com o propósito de implementar intervenções na pratica clínica para prevenir, minimizar e/ou controlar as alterações relacionadas à sexualidade do paciente, contribuindo para a melhoria da assistência de enfermagem e, consequentemente, para o sucesso do tratamento / The end-stage liver disease significantly reduces the quality of life of patients. However, with organ transplantation it is possible to improve health conditions. Sexuality is a central aspect of the human being throughout the life cycle. It is a complex area of the human behavior and therefore the sexuality of liver transplant candidates and recipients should not be overlooked. The present study aimed to analyze the evidence available in the literature on the changes in the sexuality of candidates and recipients of liver transplant. This is an integrative literature review, and the databases selected for the search of the primary studies were PubMed, CINAHL and LILACS. The 16 primary studies included in the review were grouped into three categories: (1) female sexuality (n = 5), (2) male sexuality (n = 5) and (3) male and female sexuality (n = 6). In category 1, the main research topics were contraception, pregnancy, sexual dysfunction, presence of gynecological symptoms and sexually transmitted disease. In category 2, the focus of the primary studies grouped was erectile dysfunction, it was also investigated the sexual desire/satisfaction, and the consequences of men who had children under immunosuppressive regimen with mycophenolic acid. In category 3, the evaluation of sexual function was the main topic addressed in the studies analyzed. Sexuality is a challenging problem, enrobed with taboos and prejudices, and experienced differently by individuals. Thus, patients may present difficulties in reporting their problems to health professionals, leading to delays in diagnosis and treatment, prolonging feelings of discomfort and distress. The difficulty in addressing sexuality also occurs on the part of health professionals who do not receive adequate training. Knowledge about the doubts and problems experienced by candidates and recipients of liver transplant can facilitate the implementation of interventions aimed at prevention, reduction or control of complications in the pre- and post-transplantation period. The present study provided subsidies to encourage health professionals to incorporate sexuality in the care routine of these patients, it also indicated gaps in knowledge for the conduct of new research with the purpose of implementing interventions in clinical practice to prevent, minimize and/or to control the changes related to the patient\'s sexuality, contributing to the improvement of nursing care and, consequently, to the success of the treatment

In recent decades, research from across the social sciences has demonstrated a strong, consistent and causal link between unemployment and a wide range of negative outcomes. These outcomes go beyond economic problems, incorporating issues such as low well-being, poor health and weak social capital. During the same time, successive UK governments have expanded the use of active labour market programmes (ALMPs): a wide range of interventions that aim to move unemployed people closer to the labour market. ALMPs have been widely evaluated since becoming a central part of UK social policy, yet the majority of studies focus almost exclusively on economic outcomes, such as re-employment and wage levels. This is despite the weight of evidence suggesting unemployment is as much a social problem as an economic one. This discrepancy has led to a small but growing body of research suggesting that ALMPs might play a role in modifying some of the health and social costs of unemployment: beyond simply moving people closer to the labour market. Using a mixed methods research design, this study examines whether ALMPs achieve this by considering four key questions. First, are ALMPs associated with higher well-being, health and social capital compared to the alternative of 'open unemployment'? Second, if there is an association, how robust is this and is there any evidence of a causal function? Third, does the context of an ALMP - such as the specific type of scheme and the kind of participant - matter for understanding outcomes? And fourthly, how and why do people's experiences of unemployment and ALMPs shape their health and well-being? The findings presented in this thesis offer five original contributions to the study of the health and social effects of ALMPs. First, there is a dichotomy in the effects of ALMPs: participants have higher well-being than the openly unemployed but similar health and social capital levels. Second, ALMPs are most effective in changing how participants feel about and evaluate their lives but are largely unsuccessful in mitigating negative emotions like anxiety. These two findings are evident in both cross-sectional and longitudinal data, suggesting the possibility of a causal function of ALMPs. Together, the findings suggest that the positive well-being effects of ALMPs are not necessarily linked to improved health or social capital but because participants begin to think about their lives in a different, more positive way. Third, well-being gains are experienced by both short-term and long-term unemployed people but disappear upon re-employment. This finding has an important implication for policy, with ALMPs seemingly effective as a short-term protective well-being measure. Fourth, this is the first UK study to explore whether ALMPs work more effectively for different types of unemployed people. The findings presented in Chapter Seven show that work-oriented ALMPs are more successful than employment-assistance programmes, whilst men, younger people, those with fewer qualifications, lower occupational status and lower pre-programme well-being experience the largest benefits of participation. Fifth, the qualitative analysis presented in Chapter Eight argues that ALMPs worked best when schemes reversed the perceived ‘losses’ associated with unemployment. Three processes of loss were identified - agency loss, functional loss and status loss – which, it is contended, help explain both the observed effects of ALMPs and the broader experience of unemployment. The thesis concludes with policy suggestions for improving the capacity of ALMPs to mediate the experience of unemployment.

This research project was an assessment of the client satisfaction with a newly developed multi-service unit (MSU) for "hard-to-serve" welfare recipients in San Bernardino, California.

The purpose of this study was to evaluate the effectiveness of the relationship between participation in one community college EOPS & CARE program and participant sense of preparedness for self-sufficiency.

The popularity of agile methodologies is steadily increasing. This study is an intent to balance the agile change literature with a psychological perspective and quantitative measures of an agile change made within a Swedish organization. Organizational change recipients’ beliefs (discrepancy, appropriateness, valence, efficacy, &amp; principal support) and trust in management were measured in an online survey to see how well these variables could predict a successful agile change towards transparency. The results indicate a lack of support for several previously cited success factors in the agile literature and a need for more quantitative and research-driven literature. No support could be found for a relationship between discrepancy, appropriateness, valence, principal support, trust in management, and the outcome of a successful implementation of transparency. Efficacy was found to be a significant and robust predictor of the outcome. More research is needed to ensure the generalizability of the results.

Diese Arbeit konzentriert sich auf die relative syntaktische Position polnis- cher inhärenter Dative. In semantischer Hinsicht schlagen wir vor, dass alle dativmarkierten Argumente in polnischer Sprache eine Entität bezeichnen, die geistig von einer Veränderung, einem Zustand oder einem Prozess betroffen ist, der im persönlichen Bereich der als Dativ-DP lexikalisierten Entität stattfindet. In syntaktischen Begriffen schlagen wir vor, dass polnische Dativ-DP Applikative sind, die von einem Appl-Kopf lizenziert wurden, und dass sie je nach ihrer syntaktischen Position in zwei Typen vorkommen, tief und hoch. Tiefe Applikative verschmelzen unter v, während hohe Applikative darüber verschmelzen. Die Verschmelzungsposition eines Applikativs bestimmt sein syntaktisches Verhalten. Wir zeigen, dass im Gegensatz zu tiefen Applikativen hohe Applikative Anaphern vorangehen können, zusätzliche Partizipialsätze kontrollieren und sekundäre Prädikate darstellen können. Wir schlagen vor, dass diese Unterschiede eine zuverlässige Diagnose für die Anwendungstypen in polnischer Sprache darstellen. Mit diesen Tests analysieren wir polnische Rezipienten und Benefiziäre als tiefe Applikative und polnische Experiencer als hohe Applikative. Darüber hinaus unterscheiden wir zwischen freien Applikativen, z. B. Benefiziäre im Polnischen, und gewählten, z. B. Rezipienten im Polnischen. Vom Verb gewählte Applikative verschmelzen zuerst als Teil von v oder der Wurzel und werden bei der Bewegung zu [Spec;ApplP] zu Applikativen. Im Gegensatz dazu werden nicht gewählte Applikative direkt in [Sepc;ApplP] verschmolzen, d. h. sie werden als Applikative geboren. Wir schlagen einen Partizipanten-Implikationstest vor, um zwischen diesen beiden Typen zu unterscheiden. Wenn wir die Analyse über polnische Dative hinaus erweitern, nehmen wir an, dass es sprachübergreifend zwei Arten von Applikativen gibt: verb-intern, projiziert als Teil von vP / VP und verb-extern, projiziert als Teil von ApplP. Wir nehmen polnische Dative als letztere an. / This thesis focuses on the relative syntactic position of Polish inherent datives. In semantic terms, we propose that all dative-marked arguments in Polish de- note an entity mentally affected by a change, state or process which takes place within the personal sphere of the entity lexicalised as a dative DP. In syntactic terms, we propose that Polish dative DPs are applicatives, licensed by an Appl head, and that they come in two types, low and high, depend- ing on their syntactic position. Low applicatives merge below v while high applicatives merge above it. The merge position of an applicative determines its syntactic behaviour. In contrast to low applicatives, high applicatives can antecede anaphors, control adjunct participial clauses and depictive secondary predicates. We propose that these differences constitute reliable diagnostics for applicative types in Polish. With these tests, we analyse Polish recipients and benefactives as low applicatives and Polish experiencers as high applicatives. Moreover, we distinguish between applicatives that are free, e.g. benefactives in Polish, and those that are selected, e.g. Polish recipients. Applicatives selected by the verb merge first as part of v or the root, and they become applicatives on movement to [Spec;ApplP]. In contrast, non-selected applicatives merge directly in [Spec;ApplP], i.e. they are born as applicatives. We propose a participant im- plication test to differentiate between these two types. Moreover, extending the analysis beyond Polish data, we hypothesise that cross-linguistically, there exist two types of applicatives, verb-internal, projected as part of vP / VP, and verb-external, projected as part of ApplP. We take Polish datives to be of the latter type.